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ADULT RELEASE OF LIABILITY WAIVER

CAUTION: PLEASE READ CAREFULLY BEFORE SIGNING

CAUTION:  Be Advised That Equine Activities Take Place On The Premises And That All Equine Activities Can Involve Inherent Risks Despite All Safety Precautions.  Participate At Your Own Risk At All Times.

Be it hereby known:

“Inherent risks of equine activities” shall mean those risks, dangers or conditions which are an integral part of equine activities, including, but not limited to:

(a)          The propensity of any horse to behave in unpredictable ways that may result in injury, harm or death to persons on or around them, and/or damage to property in their vicinity, and whether the person is walking nearby, mounting, riding or dismounting; No horse is a completely safe horse. Regardless of a horse’s training or past experience, a horse may, without warning or any apparent cause, buck, stumble, fall, rear, bite, kick, run, stop short, make unpredictable movements, spook, jump obstacles, step on a person’s feet, push or shove a person, saddles or bridles may loosen or break, all of which may cause Rider to fall or be jolted, resulting in property damage, personal injury or death.

(b)          The unpredictability of a horse’s reaction to such things as thunder, lightning, rain, wind, and wild and domestic animals, sights, lights, man-made or Mother Nature’s sounds, sudden movement, unfamiliar objects, insects or other people and horses, and reptiles which may walk, run, fly near, bite and/or sting a horse or person, irregular foot on groomed or wild land which is subject to constant change according to weather, temperature, natural and man-made and the inherent tendency to bite, bolt and run, stampede, trample, step on a person, push against a person, buck or throw the rider, or rear up and fall on a person.

(c)          There are other inherent risks other than those listed above, obvious and not obvious, and the undersigned Rider acknowledges that this release and exculpatory agreement is not confined to the above list, but shall be liberally construed to include any possible risk or combination of risks possible relating to equine activities.

Please read and check the following statements:

I understand that some Miller Horse Farm activities take place in isolated or wilderness areas over rough terrain, and/or trails of unknown condition. I also understand that horseback riding is a rugged adventure, recreation sport activity.  I am aware that there are numerous obvious and non-obvious inherent risks of serious injury or death, or property damage, to me or my horse, which are always present in Miller Horse Farm activities, on or near horses. 

I Agree

Upon mounting a horse and taking up the reins, Rider is in primary control of the horse, and Miller Horse Farm is not responsible for Rider’s actions or inactions. Rider’s safety depends upon his or her ability to carry out simple instructions, and his or her ability to remain balanced aboard the horse. Rider is responsible for his or her own safety.  

I Agree

In consideration that I will be allowed to participate in any horse related activities that Miller Horse Farm provides, I do hereby agree that in the event I am injured or any of my party, friends, relatives, or horses are injured or suffer personal injury or property damage during my stay, that I will not, in any event, hold responsible nor present any claims or demands to Miller Horse Farm, Noah Smith, Glory Smith, or their owners, directors, officers, agents, representatives, employees and volunteers, on account of any injury that I, or any of my party may have suffered. 

I Agree

WARNING:  Miller Horse Farm advises all participants to wear protective headgear (riding helmet) and close-toed shoes.

I have been fully warned and advised by Miller Horse Farm that I should wear protective headgear (riding helmet), and that the wearing of such headgear while mounting, riding, dismounting, and otherwise being around horses, may prevent or reduce severity of some head injuries and even prevent death from happening as the result of a fall or other occurrence.  I have also been warned that I should wear close-toed shoes to prevent any serious injury to my feet while on or around the horses.

I Agree

PHOTO RELEASE: I give permission for photographs taken of me or my minor while participating in this activity to be used in marketing and/or public relations material.

I Agree

Participant Hereby Further Acknowledges that he/she has had the opportunity to carefully read, review and clarify any questions he/she might have pertaining this Release Agreement before their signing below. The Participant hereby acknowledges they have read and understand the legal and binding effect of this Release Agreement, and expressly agrees to be bound hereby now and at all times in the future. 

I Agree

I am in good physical health and have the ability to safely engage in equine activities.

I Agree

The Participant hereby voluntarily and enters into this Contract and Agreement this date: October 17, 2021

THIS BINDING LEGAL AGREEMENT AFFECTS IMPORTANT LEGAL RIGHTS.  I HAVE READ AND UNDERSTOOD THIS DOCUMENT AND AGREE TO BE BOUND BY IT.  Participant’s Initial:

 

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Information
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Information
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Information
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information
Parent or Guardian's Email Address

Email
A signed copy of this waiver will be sent to the email address you provide.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Information
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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